ArticlePDF Available

An Experimental Study of the Effects of Energy Intake at Breakfast on the Test Performance of 10-Year-Old Children in School

Authors:

Abstract

In order to examine the effect of energy intake at breakfast on school performance the same morning, the parents of ten parallel school classes of 10-year-old school children at five different schools were persuaded to alter their child's breakfast regimen at home over a period of 4 successive days. A total of 195 families were provided with standard breakfasts with either low or high energy content. Uneaten food was returned and weighed. Individual children were randomly assigned to breakfast alternative on any given day. The teachers who carried out the performance assessments at school were blind to treatment condition. Voluntary physical endurance and the performance of a creativity test were significantly better after a breakfast from which children derived over 20% of their recommended daily energy intake than after a breakfast from which they obtained less than 10% of recommended values. The error rate in an addition task was negatively correlated and the rate of working in a number checking task was positively correlated with individual energy intake from the low-energy breakfast. Significantly fewer children reported feeling bad and self-estimates of hunger sensation were lower during the morning at school after the high energy breakfast. Estimates of energy intake at breakfast based on 24-h dietary recall interviews with the children carried out by telephone at their homes showed good correlation with estimates based on returned food (r = 0.89). Energy intake at breakfast as estimated from returned food had no significant effect on energy intake at school lunch as estimated by dietary recall.
Title: Systematic review and meta-analysis of data relating to wheat bran intake and blood
lipids, specifically triglycerides.
Authors:
Jolene McMonagle PhD1, , Reg J. Fletcher 1, Janice I. Harland PhD2
Affiliation:
1HarlandHall
The Stables,
Ranbury Ring,
London Road
Poulton,
Cirencester,
GL7 5HN England
1
2Kellogg European Headquarters
Lakeshore Drive,
Airside Business Park,
Swords,
Co Dublin
Eire
2
HarlandHall
The Stables,
Ranbury Ring,
London Road
Poulton,
Cirencester,
GL7 5HN England
Author responsible for correspondence:
Jolene McMonagle
Short title/running head:
Effect of wheat bran fibre on blood triglycerides
Key words:
wheat bran, blood lipids, triglycerides, cardiovascular risk
Text word count: 247
































Abstract
Objective:
To review the evidence relating to wheat bran fibre intake (WBF) and their effect on blood
lipids.
Design:
Systematic review and meta-analysis of intervention studies reporting WBF intake and blood
lipids, specifically triglycerides concentrations (TAG).
Setting:
Medline and other scientific databases were searched for the period 1966–2011 to produce a
full reference list of articles for review.
Methods:
A matrix of eligibility for study inclusion was established; 13 intervention studies conducted
with 281 broadly healthy adults met the criteria and were retained for further analysis. Using
standard meta-analysis techniques, standard mean difference in blood lipids following WBF
intake were calculated. Meta-regression analysis of added WBF intake on mean difference
blood TAG was also conducted.
Results
Diets incorporating an average of 17.3 g/day WBF resulted in a reduced standard mean
difference in blood TAG of 0.178 mmol/L, (95% CI -0.303, -0.053), P=0.005. There was
some evidence of an inverse dose-response relationship between added wheat bran intake (g
dietary fibre /day) and net change in mean TAG, which failed to reach statistical significance,
P =0.066.
There were minor changes and significant heterogeneity in other blood lipid data, except for
very low density lipoprotein (VLDL) cholesterol, which on the basis of limited data from
four studies was reduced by -0.102 mmol/L (95% CI -0.162, -0.043), P=0.001.
Conclusion
The addition of 17.3g /day WBF to the diet significantly lowered blood TAG by 0.178
mmol/L, equivalent to 8.6% reduction compared to baseline, without adverse effects on other
blood lipids.


































 !
"#
Introduction
MetS and personalised nutrition
Elevated plasma TAG concentrations and low levels of high-density lipoprotein (HDL)
cholesterol are recognised cardiovascular risk factors, although attention is usually focussed
on low density lipoprotein (LDL) cholesterol as a prime risk factor. The pivotal role that
plasma TAG concentrations play in lipid metabolism is the subject of a recent consensus
statement from the American Heart Association (AHA), who after reviewing the evidence,
has confirmed that blood TAG, more appropriately, represent a biomarker of CHD risk rather
than an independent risk factor 1. However, it is recognised that in some individuals at risk
from cardiovascular disease (CVD) or insulin resistance (Ri), low density lipoprotein (LDL)
-cholesterol levels may not be elevated, but TAG levels are raised. In recognition of the
importance of TAG, the AHA scientific statement suggests the following new designations:
optimal fasting TAG levels are defined as <100 mg/dL (1.13 mmol/L), as a parameter of
metabolic health, borderline high fasting TAG levels are 150 to 199 mg/dL ( 1.7 to 2.2
mmol/L), high levels are 200 to 499 mg/dL ( 2.3 to 5.6 mmol/L) and very high levels ≥500
mg/dL (5.6 mmol/L). This reduction of the upper "normal" level of TAG to (≥ 1.7 mmol/L)
was also recently endorsed in a critical appraisal of the evidence relating to elevated levels of
triglyceride-rich lipoproteins (TRLs) by the European Atherosclerosis Society Consensus
Panel 2, who also recommended the targeting of elevated TAG (≥ 1.7 mmol/L) as a marker of
TRL 3.
An extensive collaborative review of 101 studies identified that those with a genetic tendency
for high levels of triglycerides also had a greater risk of heart disease, providing evidence for
a causal association between triglyceride-mediated pathways and CHD 4.
Approximately 31% of the adult US population has a triglyceride level > 1.7mmol/L with no
appreciable change between the National Health and Nutrition Examination Surveys
(NHANES) of 1988–1994 and 1999–2008 data 1. Where increases in TAG have been
observed, this is primarily in younger age groups (20 to 49 years old), and overall, TAG
levels continue to be higher than in less industrialized societies 1. Taking a longer
perspective, mean TAG levels have risen since 1976, associated with exponential increases
in obesity, insulin resistance, and type 2 diabetes, while LDL cholesterol have not changed.



































Quantification of the association between serum TAG and the risk of CHD was recently
undertaken using data from the European Prospective Investigation of Cancer (EPIC)-
Norfolk and Reykjavik studies 5. Two separate nested case-control comparisons were
conducted involving 3582 incident cases of fatal and nonfatal CHD and 6175 controls
selected from among the 44,237 men and women screened in the population studies. The
long-term stability of log-triglyceride values (within-person correlation coefficients of 0.64
(95% CI 0.60, 0.68) and 0.63 (95% CI 0.57, 0.70) over 4 and 12 years respectively) was
similar to those of blood pressure and total serum cholesterol. After adjustment the strength
of the association was attenuated, and the adjusted odds ratio (OR) for CHD was 1.76 (95%
CI 1.39, 2.21) in the Reykjavik study and 1.57 (95% CI 1.10, 2.24) in the EPIC-Norfolk
study, when the top third of individuals were compared with those in the bottom third of
values. A meta-analysis involving a total of 10,158 CHD cases from 262,525 participants in
29 studies also indicated an increased risk of CHD with elevated blood TAG; adjusted OR
was 1.72; (95% CI 1.56, 1.90) 5. Further epidemiological evidence is provided by a cohort of
1232 high-risk men aged 40-49 y followed for 23 years in the Oslo Diet and Antismoking
Trial. In this study normalising TAG, by lifestyle interventions in men with elevated TAG,
was associated with an reduced risk of ischemic heart disease (IHD) events; hazard ratio of
IHD events was 0.56 (95% CI 0.34, 0.93; P = 0.027) 6.
While an association between elevated TAG and CHD exists, the extent to which it is
independent of other risk factors of CHD remains less clear. For example, the treatment of
elevated TAG levels is often undertaken with interrelated lifestyle changes such as weight
loss; a 5% to 10% reduction in body weight may result in a triglyceride-lowering response of
20% with both factors contributing to the reduction in CHD risk 1. Elevated blood TAG is
also evident in Type 2 diabetics and high TAG levels accompanying either normal or
impaired fasting glucose can predict its development, as well as being one of the key risk
factors for the Metabolic Syndrome.Maintenance of normal blood concentration of TAG is
clearly a beneficial physiological effect and effective dietary management of elevated TAG
levels is an area that requires further attention. Contrary to traditionally-held opinion, it has
been shown that the long-term within-individual variability of TAG is no greater than that of
other lipid fractions 7; as such, it could provide a target for monitoring and intervention.
While an increase in fibre intake is considered desirable in diets for both diabetics and those
at risk from CHD, the focus of research has tended to be on the extent to which soluble


































sources of fibre 8-11 or mixtures of whole-grain cereals can contribute 12. The objective of this
study was however, to investigate the role that can be played by well-characterised less
soluble cereal fibre, WBF, in modifying blood lipids specifically, blood TAG. In Western
populations, wheat is the predominant source of fibre or non-starch polysaccharide (NSP)
intake 13-15. Wheat bran has long been recognised as beneficial in gut transit and faecal
bulking16, although in studies related to blood lipid metabolism it has largely been considered
inert and has often been used as a control. A further objective of this study was to establish if
this assumption was valid.
Materials and methods
Searching
Computerised scientific publication databases were searched. The search was focused on
Medline (www.ncbi.nlm.nih.gov/entrez/query.fcgi) for the period January 1966 through to
November 2011 and was confined to human studies but no language restriction was imposed.
It was complemented by searches in EMBASE and hand search of key papers and references
cited in identified articles. In addition, the reference lists in identified papers were scrutinised
for further studies. Initial search terms were ‘wheat bran' or 'wheat fibre (fiber)' or 'cereal
bran or fibre (fiber)' or 'whole wheat' and 'blood or plasma or serum triglycerides' or
'cholesterol' or 'blood or plasma or serum lipids'. The search strategy was applied to titles and
abstracts only, in order to identify studies where interventions related WBF were the primary
intervention and not the control or placebo.
Data abstraction and quality assessment
The review of identified papers was conducted according to the QUORUM principles17 (Fig.
1). Studies were retained where the introduction of wheat bran fibre was a primary
intervention. Studies could be either crossover or parallel in design and should compare
WBF to baseline or a suitable control. WBF could be sourced from bran flakes or bran-rich
foods or whole wheat foods. Subjects were broadly healthy volunteers were healthy or mildly
hypercholesterolaemic, with average weight loss <1 kg/week and average BMI < 35; study
duration was a minimum of 3 weeks. Studies were excluded when participants were taking
lipid-lowering drugs or antihypertensive medication. The fibre content of the supplement
should be reported and measured using the method of the Association of Official Analytical
Chemists (AOAC), the Englyst method for non-starch polysaccharides (NSP), Southgate
method or a recognised method of dietary fibre analysis. Studies using a blend of different


































cereal fibres or multiple cereals such as undefined wholegrains were excluded, as were
studies reporting fibre determined by crude fibre analysis.
Fig. 1 near here
The key characteristics of the studies were abstracted and the findings collated, which
included: identification of the number of subjects, gender, age, duration of study,
measurements of blood lipids, macronutrient content of the diet, definition of fibre and
method of assessment of intake. The data abstracted were subject to quality assessment in
three main areas: recruitment and flow of subjects through the study, dietary assessment and
treatment and reporting of data.
$%&    ' "
"  $()    "  %""  *+,-    ,+,-  %""    %
.""  .  "    "&&  /0,+,1  %""#  2  ."
&"-"%#
Statistical methods
2   . /3#+#1 4 % %  " "& ."
  ""  4  .    %  &&""  "  &  
"4""-&#5%4""
%    6  ' &&%    7  6  ."  /8!1 
""#*""*98%9
:#  $    %  .""     '  ;  %
%%&"4%".4 %
"  "&  "."#  2-  "      %  
&%&5<=>
/    6?1     %    $()#Comprehensive Meta-Analysis
software (Biostat, Englewood, NJ 07631, USA) was used for all statistical analysis
Results
Trial flow
Fig. 1 outlines the results from the reported review process. The search identified 116 papers;
when abstracts were scanned and exclusion criteria applied, this resulted in 31 potentially
relevant studies. After reading the full articles, 14 treatment arms from 13 studies were




































retained for further analysis 18-30. In addition to reporting some measure of blood lipids and
WBF intake, retained studies measured macronutrient intake. This could be reported as either
total intake, or the macronutrient content of the supplement where macronutrient content of
the background diet was kept constant. Studies were not retained for further analysis for the
following reasons: nutrient intake not matched or significantly different at baseline 31-34, no
nutrient intake data 35-37, primary objective not related to WBF or wheat bran treatment
inadequately characterised 38-42, subjects not healthy 43, inadequate study duration 22, 44 and
data values not presented or presented as figures unsuitable for further analysis or pooled data
presented 30, 45-46.
Study characteristics
Details of the 13 retained papers that contained studies measuring blood lipids and with a
WBF intervention are shown in Table 1.
Table 1 near here
Retained studies included 8 randomised crossover studies (RX), 2 randomised controlled
parallel design (RCP) and 3 phased interventions, with and without WBF. Two studies were
single-blinded 19, 47, and one study double-blinded 24. Studies were conducted with 281 adult
male and females aged 18-73 years, most of whom were described as healthy, but included
mild hypercholesterolaemics and hypertensives. Study length ranged from 3-12 weeks, mean
4.6 weeks. The range of additional WBF intake was 10-22g /day. A number of analytical
techniques were used to measure fibre, most prevalent were AOAC and Southgate, which
can be expected to give similar results 48. Three studies measured NSP and by reference to
extensive data, these values were converted to be more similar to fibre determined by AOAC
by use of a conversion factor of 1.2, known to be appropriate for WBF. All studies apart from
two, reported macronutrient and energy intake 20, 26. The majority of studies were crossover
in design, the primary comparison made, was end of treatment values compared to control
end values. This approach was also used for the parallel studies, which were corrected for
baseline; for phased intervention studies end of intervention values were compared to
baseline. The average baseline blood TAG level was 1.52 mmol/L, with subjects from 2
treatment arms classified as borderline high 18, 27 and 2 classified as high 22.

































Analysis of main outcomes
Thirteen treatment arms from 12 studies provided numerical data for the primary outcome,
blood TAG; when the data was pooled the inclusion of WBF in the diet resulted in a
significant standard mean difference in TAG of -0.178 mmol/L (95% CI -0.303, -0.053),
P=0.005. Heterogeneity was not evidence in the dataset, P =0.24. See Fig. 2. The inclusion of
an average of 17.3g WBF led to a mean reduction in TAG of 8.6% compared to baseline, but
when the mean reduction was calculated using the standard mean difference data, the
reduction compared to baseline was equivalent to 22%.
Figure 2 near here.
Figure 3 near here.
Meta regression was conducted to determine whether a dose-response relationship existed
between wheat fibre intake and net change in mean TAG. From Fig. 3, it can be seen that
there is some evidence of an inverse association between WBF intake (g dietary fibre/day)
and the reduction in TAG, however the relationship just failed to reach statistical significance,
P =0.066.
Publication bias has been assessed by two methods, funnel plot of the standard error by
standard difference in mean TAG and Classic fail-safe N. The funnel plot is a plot of a
measure of study size (usually standard error) on the vertical axis as a function of effect size
on the horizontal axis, Fig. 4. Large studies appear toward the top of the graph, and tend to
cluster near the mean effect size. Smaller studies appear toward the bottom of the graph, and
(since there is more sampling variation in effect size estimates in the smaller studies) will be
dispersed across a range of values. In the absence of publication bias the studies are
distributed symmetrically about the combined effect size. This is broadly the case as shown in
Fig. 4. From this plot it can be seem that there is good symmetry around the centre line and
good distribution of the studies from top to bottom, there is a small indication of bias due to a
cluster of studies on the mid-left of the centre line. However when Classic fail-safe N is
calculated by incorporating data from 13 treatment arms, which yield a z-value of - 3.56 and
corresponding 2-tailed P-value of 0.0004. The fail-safe N is 30. This means that 30 'null'
studies would need to be located in order for the combined 2-tailed p-value to exceed 0.050
or there would be need to be 2.3 missing studies for every observed study for the effect to be
nullified indicating little evidence of bias.


































Figure 4 near here.
When data relating to total, LDL- and HDL- cholesterol were pooled there was little effect on
these parameters with total cholesterol unchanged, a small reduction in LDL- cholesterol and
an increase in HDL- cholesterol. In all three datasets there was evidence of high degree of
heterogeneity (P<0.001) (data not shown).
Four studies 18, 20-21, 29, reported data related very low density lipoprotein (VLDL) cholesterol,
in all cases VLDL was reduced and when pooled, the simple mean difference was -0.102
mmol/L (95% CI -0.162, -0.043), P=0.001. Heterogeneity was not evident (P=0.058), but as
of borderline significance, a random effects analysis was also conducted, with little effect on
the outcome (-0.106 mmol/L, 95% CI -0.200, -0.011; P=0.029).
Discussion
This is the first analysis that has specifically investigated the role of WBF intake on blood
TAG. The pooling of data from trials where there was an average intake of 17.2g dietary fibre
from wheat bran resulted in an overall significant effect on blood TAG of -0.178 mmol/L
(95% CI -0.303, -0.053) (Fig. 2) equivalent to a reduction compared to baseline of ca 9%.
From the meta regression it can be calculated that each 10g intake of dietary fibre intake was
associated with a reduction in TAG of approximately 0.1 mmol/L. The reduction in TAG was
associated with little effect on other blood lipids, with the exception of VLDL, where there
was also indication of a reduction in this lipid material. Previous assumptions that wheat bran
has little effect on blood cholesterol appear to be valid, although in respect of an effect on
blood TAG this clearly is open to question.
Nutrition modifications that can effect TAG levels have focussed on reducing overall energy
(e) intake, as it is recognised that weight loss has a beneficial effect on blood TAG 49.
Furthermore the magnitude of decrease in TAG is directly related to the amount of weight
loss and, by means of a meta-analysis, it has been estimated that for each kilogram of weight
loss, a decrease in TAG of 1.9% results 50,51. In this analysis, studies were selected where
weight loss was minimal and using the relationship described above by Anderson et al. 51, it
can be calculated that to account for the reported 8.6% reduction in TAG, there would have
had to have been a 4.5kg loss in weight, which was not the case.


































Other aspects of nutrient intake that can influence TAG levels are total fat and available
carbohydrate intake 52. In a meta-analysis of 60 studies, a 1 % isoenergetic replacement of
saturated, monounsaturated or polyunsaturated fat with carbohydrate resulted in significant
increases in fasting TAG levels of 0.021, 0.019 and 0.026 mmol/L respectively, all P<0.001,
indicating a benefit from replacing available carbohydrate with fat. A similar effect was
reported when moderate fat diets (32.5% to 50%e from fat) were compared to lower-fat diets
(18% to 30%e from fat) with a resulting decrease in TAG of 0.1 mmol/L (range from -0.07
to - 0.14 mmol/L, P<0.00001) with the moderate fat diet 53. In subjects with diabetes the
moderate fat diet intervention led to an even greater reduction in TAG 53.
Within this database of studies macronutrient content of baseline and intervention was
matched to varying degrees. There was no significant differences in the macronutrient
content reported for retained studies, however there was a difference in fat intake between
baseline and the wheat and barley interventions of 20 and 19g respectively in one study 25 and
the supplement used in one study increased protein intake by ca 60g and reduced available
carbohydrate intake by ca 70g 22. Exclusion of these three treatments from the analysis
resulted in a reduction in mean TAG which was similar to the dataset as a whole (-0.166
mmol/L; 95% CI -0.312, -0.021; P=0.025). It therefore appears likely that the fibre or some
component of the bran is the causal agent for the reduction that we have reported.
The role of fibre intervention on blood TAG is less well documented particularly in non-
diabetic subjects, although fixed-effect meta-analyses techniques have been used to obtain
mean estimates of changes in blood lipids following dietary intervention in diabetics 54. High
carbohydrate, high fibre diets compared to moderate carbohydrate, low fibre diets were
associated with lower values for fasting, postprandial and average plasma glucose, total, LDL
and HDL-cholesterol and TAG. Overall indications were that high intakes of dietary fibre
(≥20 grams/1000 kcal) in the context of moderate or high carbohydrate diets led to improved
serum lipoproteins, with reported reductions in TAG of 8.3-12.8% 54. In this analysis, total
dietary fibre intake / 1000 kcal could be estimated in ten treatments 18-25, 47 and ranged from 8
- 24g/ 1000 kcal, while added dietary fibre from wheat bran was on average 17.3g (range 7-
36g ). From this analysis it can be seen that the addition of 17.3g dietary fibre from wheat
bran was associated with a reduction in TAG of 8.6%, not dissimilar to that reported for
diabetics 54.



































$%  "."%%.%
 6>"$()#$%<+3
%      "  "&  "  &      4
""6>&&"4"
4"" 45="#!%" - ".4
$&."$()
"6-""6 -""6 #(
"  .      $()    "    6  
&%%83
">#
Wheat bran also is a source of minerals, vitamins and phenolic compounds. These phenolic
compounds provide the plant's defence system and include derivatives of benzoic and
cinnamic acid, the most extensively studied of which is ferulic acid 14. There is evidence that
intestinal microbes can release ferulic acid and other phenolics from the bran, hence these
substances or their metabolites are bioavailable and may be physiologically active, although
the mechanisms involved require further investigation 14. It is suggested that the
cardiovascular benefits may be related to folate, magnesium, vitamin B-6, vitamin E or serum
levels of enterlactone rather than the fibre per se 57.
In a recent analysis of the Nurses' Health Study, 7822 women with type 2 diabetes were
assessed for the risks of all cause and CVD mortality. After adjustment for age, lifestyle and
dietary risk factors, the strongest association that remained was an inverse association
between cereal bran intake and CVD-specific mortality. The relative risk across fifths of bran
intake were 1.0, 0.95, 0.80, 0.76 and 0.65 respectively ( P for trend = 0.04) 58. The
relationship was evident after adjustment, whereas no significant associations were evident
after adjustment, for whole-grain intake, for cereal fibre or germ intake. While cereal bran
will include other sources cereal fibre, it should be recalled that in both US and UK
populations wheat is the predominant source of whole grain cereals in the diet and is likely to
comprise at least half of cereal bran 14-15. A beneficial association between CHD and whole
grains intake in the US Health Professionals Survey also identified that the bran component
could be a key factor in the relationship 59. The mechanism responsible for this association


































between cereal bran and CVD has not been identified and it conceivable reduction in blood
TAG may be a contributing factor.
@0,+,%""""&%%"
"4%"40,+,%".&"
40,+,&""444
 de novo %&  "&      %    $()
%#  (      0,+,     $()  "  ""    %
">"%4%44%%"",+,#*%
""."40,+,%"" $() &%
%"%"&&&&6"">480+#
There are a number of limitations in this analysis, the quality of identified studies was
variable, few studies were blinded, the nature of the control was variable and a number of the
studies compared wheat with oats, where wheat bran it could perhaps be implied, was a
control treatment. The analytical determination of dietary fibre was undertaken principally by
AOAC technique, but NSP (adjusted) and other measures were also used giving rise to
another source of variation. The presentation of WBF to subjects took a variety of different
forms including bran supplements breakfast cereals, bread, biscuits, muffins, wheat whole-
grain foods and supplements. The effect which food processing techniques employed during
the manufacture of the WBF foods have on bioavailailabilty of WBF components critical for
the mechanism of action is uncertain.
Nevertheless the inclusion of a modest intake of wheat bran resulted in a small TAG lowering
effect, which may contribute to reduction of cardiovascular risk. Overall, its addition to
optimisation of nutrition interventions, such as reductions in available carbohydrate,
restriction in added sugars and fructose, reduction in trans and saturated fatty acid intake and
optimal consumption of long-chain omega-3 fatty acids can contribute to a TAG-lowering
effect that ranges between 20% and 50% 1.
Acknowledgements
The provision of a unconditional grant from the Kellogg Group of European Companies is
gratefully acknowledged.


































Table 1 Details of the intervention studies included in the present systematic review and analysis
Author
Studies
Year
Control Intervention
Food/constituent
Daily intake
(constituent)
Fibre
intake
Fibre
method
Interve
ntion
time
Study
type
Sex
N
Population
Anderson
1991 18
Control diet
41% e fat, 16%
e protein, 43% e
CHO 18g DF all
foods prepared
& eaten in
metabolic ward
Control diet +
either wheat or oat
bran
40g wheat bran
from breakfast
cereal + wheat bran
muffins
34g
wheat
DF
7.8g
soluble
F
Total
dietary
fibre as
USDA
data-base
21days RCT P 20 M Hypocholesterolae
mic >5.2 mmol/L
TC, TAG <3.4
mmol/L, BMI
>28.7; 38-73 y, no
medication, but 14
had diagnoses of
hypertension, CHD
or CVD
Bremer
199119
Phase II AHA
diet to stabilise
blood lipids
Bread with oat bran
or wheat
15.3g
wheat
DF
AACC 4wk RT SB
X
5 M/
7F
Hyperlipidaemics,
TC 5.7-9 mmol/L ,
38-66 y
Gariot
198620
Control diet all
foods prepared
& eaten in
metabolic unit
+20g wheat bran
prepared as bread
+20g
WB @
59%F
11.8g
wheat
F
South-
gate
7 wk PIT 4 M Healthy
Giacco
201021
Refined wheat Whole wheat
+13.3g F ex whole
wheat
+13.3g
wheat
F
AOAC 3wk RCT
X
12 M/
3 F
Healthy, BMI
27.4+/-3.0,
54.5 y +/-7.6
Jenkins
197523
Control diet all
foods prepared
& eaten in
metabolic unit
Wheat bran +36g
wheat
F
South-
gate
3wk RT X 6 M Healthy
Jenkins
1999 22
Study 1
metabolic study.
Control low
fibre bread.
Wheat bran
medium or ultra
fine +gluten
Wheat bran and
gluten in prepared
breads
+19g
wheat
DF
AOAC 1mo RCT
X
16M/
8F
Healthy (1 F on
HRT) BMI 17.9-
31.5,
35-72y
Kestin White bread Bread with 12g +12g/ NSP 4wk RCT 24M Mild





1990 24 Low fibre diet
<12g NSP
wheat bran day
wheat
F
DB X
Latin
square
hypercholesterolae
mic
McIntosh
1991 25
No control 2
treatments
Bread/muesli/spagh
etti/biscuits with
wheat or barley
fibre
+17.2g
/day
NSP
NSP 4wk RT X 21M Mild
hypercholesterolae
mic
30-59 y
Moore
1984 26
With and
without bran
Wheat bran
0.15g/kg/Bwt
+7.2 to
11.9g /
day
South-
gate
6wk PIT 3 M/
4 F
Healthy 18-22 y
Rave 2007
27
No control 2
treatments
200g/day
Balantose™
(Cargill) Double
fermented whole
grain wheat
+21.4g/
day
wheat
F
AOAC 4 wk RT X 13M/
18F
Free living obese,
BMI >29 to
< 40 kg/m2 with
elevated blood
glucose >6·1 and
≤ 7·1 mmol/L
Tighe 2010
47
Refined diet
intake 10-12g
NSP
3 servs whole-grain
wheat foods
+6.2g/
day
wheat
F
NSP 12wk RCT
SB P
186
M/F
Healthy middle
aged
van Berge-
Henegouw
en 1979 29
Habitual diet Coarse wheat bran
0.5g/kg/Bwt +33.5
to 37.8g wheat
bran/day
+20.8g
DF
wheat
F
58.3%
DF
Van
Soest
4wk PIT 7 M Healthy, 18-24 y
Vuksan
2011 30
No control, 3
treatments
Fibre from
breakfast cereals or
sprinkled
14g DF/ 4184 kJ
from All Bran/Bran
Buds + viscous
fibre
+12g
DF
from
wheat
F
AOAC? 21 d RT X 12 M/
11 F
Healthy, LDL-C
2.9 mmol/L,
35 (SD 12) y



Abbreviations: NG - not given, M male, F female, wk week, RCT - randomised controlled
trial; P - Parallel; X - crossover study; PIT - Prospective intervention trial; DB - Double blind;
SB - Single blinded; F fibre; DF dietary fibre; NSP non starch polysaccharides; BWt body
weight; servs servings; C= control; I = intervention;
References
[1] Miller M, Stone NJ, Ballantyne C, et al. (2011) Triglycerides and cardiovascular disease: a scientific
statement from the American Heart Association Circulation 123, 2292-333.
[2] Abdel-Maksoud M, Sazonov V, Gutkin SW, et al. (2008) Effects of modifying triglycerides and
triglyceride-rich lipoproteins on cardiovascular outcomes J Cardiovasc Pharmacol 51, 331-51.
[3] Chapman MJ, Ginsberg HN, Amarenco P, et al. (2011) Triglyceride-rich lipoproteins and high-density
lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management
Eur Heart J 32, 1345-61.
[4] (2010) Triglyceride-mediated pathways and coronary disease: collaborative analysis of 101 studies The
Lancet 375, 1634-9.
[5] Sarwar N, Danesh J, Eiriksdottir G, et al. (2007) Triglycerides and the risk of coronary heart disease:
10,158 incident cases among 262,525 participants in 29 Western prospective studies Circulation 115, 450-8.
[6] Ellingsen I, Hjermann I, Abdelnoor M, et al. (2003) Dietary and antismoking advice and ischemic heart
disease mortality in men with normal or high fasting triacylglycerol concentrations: a 23-y follow-up study Am
J Clin Nutr 78, 935-40.
[7] Sarwar N, Sattar N (2009) Triglycerides and coronary heart disease: have recent insights yielded
conclusive answers? Curr Opin Lipidol 20, 275-81.
[8] Brown L, Rosner B, Willett WW, et al. (1999) Cholesterol-lowering effects of dietary fiber: a meta-
analysis Am J Clin Nutr 69, 30-42.
[9] Talati R, Baker WL, Pabilonia MS, et al. (2009) The effects of barley-derived soluble fiber on serum
lipids Annals of family medicine 7, 157-63.
[10] Pins JJ, Kaur H, Dodds E, et al. (2007) The effects of cereal fibers and barley foods rich in beta-glucan
on cardiovascular disease and diabetes risk. In Whole grains and health. Marquart L, Jacobs DR Jr, McIntosh
GH, Poutanen K, Reicks M eds. London: Blackwell, 2007: 75-85.
[11] Ripsin CM, Keenan JM, Jacobs DR, Jr., et al. (1992) Oat products and lipid lowering. A meta-analysis
Jama 267, 3317-25.
[12] Mellen PB, Walsh TF, Herrington DM (2007) Whole grain intake and cardiovascular disease: A meta-
analysis Nutr Metab Cardiovasc Dis.
[13] Lang R, Thane CW, Bolton-Smith C, et al. (2003) Consumption of whole-grain foods by British adults:
findings from further analysis of two national dietary surveys Public Health Nutr 6, 479-84.
[14] Jonnalagadda SS, Harnack L, Liu RH, et al. (2011) Putting the whole grain puzzle together: health
benefits associated with whole grains--summary of American Society for Nutrition 2010 Satellite Symposium J
Nutr 141, 1011S-22S.
[15] Thane CW, Jones AR, Stephen AM, et al. (2007) Comparative whole-grain intake of British adults in
1986-7 and 2000-1 Br J Nutr 97, 987-92.










































[16] Cummings JH (1993) The Effect of Dietary Fiber on Fecal Weight and Composition. In CRC
Handbook of Dietary Fiber in Human Nutrition, 2nd Edition, pp. 263-349 editor^editors|]. City|: Publisher|.
[17] Clarke M (2000) The QUORUM statement Lancet 355, 756-7.
[18] Anderson JW, Gilinsky NH, Deakins DA, et al. (1991) Lipid responses of hypercholesterolemic men to
oat-bran and wheat-bran intake Am J Clin Nutr 54, 678-83.
[19] Bremer JM, Scott RS, Lintott CJ (1991) Oat bran and cholesterol reduction: evidence against specific
effect Aust N Z J Med 21, 422-6.
[20] Gariot P, Digy JP, Genton P, et al. (1986) Long-term effect of bran ingestion on lipid metabolism in
healthy man Ann Nutr Metab 30, 369-73.
[21] Giacco R, Clemente G, Cipriano D, et al. (2010) Effects of the regular consumption of wholemeal
wheat foods on cardiovascular risk factors in healthy people Nutr Metab Cardiovasc Dis 20, 186-94.
[22] Jenkins DJ, Kendall CW, Vuksan V, et al. (1999) Effect of wheat bran on serum lipids: influence of
particle size and wheat protein J Am Coll Nutr 18, 159-65.
[23] Jenkins DJ, Hill MS, Cummings JH (1975) Effect of wheat fiber on blood lipids, fecal steroid excretion
and serum iron Am J Clin Nutr 28, 1408-11.
[24] Kestin M, Moss R, Clifton PM, et al. (1990) Comparative effects of three cereal brans on plasma lipids,
blood pressure, and glucose metabolism in mildly hypercholesterolemic men Am J Clin Nutr 52, 661-6.
[25] McIntosh GH, Whyte J, McArthur R, et al. (1991) Barley and wheat foods: influence on plasma
cholesterol concentrations in hypercholesterolemic men Am J Clin Nutr 53, 1205-9.
[26] Moore DJ, White FJ, Flatt PR, et al. (1985) Beneficial short-term effects of unprocessed wheat bran on
lipid and glucose metabolism in man Hum Nutr Clin Nutr 39, 63-7.
[27] Rave K, Roggen K, Dellweg S, et al. (2007) Improvement of insulin resistance after diet with a whole-
grain based dietary product: results of a randomized, controlled cross-over study in obese subjects with elevated
fasting blood glucose Br J Nutr 98, 929-36.
[28] Tighe P, Duthie G, Vaughan N, et al. (2010) Effect of increased consumption of whole-grain foods on
blood pressure and other cardiovascular risk markers in healthy middle-aged persons: a randomized controlled
trial Am J Clin Nutr 92, 733-40.
[29] van Berge-Henegouwen GP, Huybregts AW, van de Werf S, et al. (1979) Effect of a standardized wheat
bran preparation on serum lipids in young healthy males Am J Clin Nutr 32, 794-8.
[30] Vuksan V, Jenkins AL, Rogovik AL, et al. (2011) Viscosity rather than quantity of dietary fibre predicts
cholesterol-lowering effect in healthy individuals Br J Nutr 106, 1349-52.
[31] Anderson JW, Riddell-Mason S, Gustafson NJ, et al. (1992) Cholesterol-lowering effects of psyllium-
enriched cereal as an adjunct to a prudent diet in the treatment of mild to moderate hypercholesterolemia Am J
Clin Nutr 56, 93-8.
[32] Connell AM, Smith CL, Somsel M (1975) Absence of effect of bran on blood-lipids Lancet 1, 496-7.
[33] Reyna-Villasmil N, Bermudez-Pirela V, Mengual-Moreno E, et al. (2007) Oat-derived beta-glucan
significantly improves HDLC and diminishes LDLC and non-HDL cholesterol in overweight individuals with
mild hypercholesterolemia Am J Ther 14, 203-12.







































[34] Jenkins DJ, Kendall CW, Marchie A, et al. (2002) Dose response of almonds on coronary heart disease
risk factors: blood lipids, oxidized low-density lipoproteins, lipoprotein(a), homocysteine, and pulmonary nitric
oxide: a randomized, controlled, crossover trial Circulation 106, 1327-32.
[35] Durrington P, Wicks AC, Heaton KW (1975) Letter: Effect of bran on blood-lipids Lancet 2, 133.
[36] Heaton KW, Pomare EW (1974) Effect of bran on blood lipids and calcium Lancet 1, 49-50.
[37] McDougall RM, Yakymyshyn L, Walker K, et al. (1978) Effect of wheat bran on serum lipoproteins
and biliary lipids Can J Surg 21, 433-5.
[38] Bloedon LT, Balikai S, Chittams J, et al. (2008) Flaxseed and cardiovascular risk factors: results from a
double blind, randomized, controlled clinical trial J Am Coll Nutr 27, 65-74.
[39] Davy BM, Melby CL, Beske SD, et al. (2002) Oat consumption does not affect resting casual and
ambulatory 24-h arterial blood pressure in men with high-normal blood pressure to stage I hypertension J Nutr
132, 394-8.
[40] Romero AL, Romero JE, Galaviz S, et al. (1998) Cookies enriched with psyllium or oat bran lower
plasma LDL cholesterol in normal and hypercholesterolemic men from Northern Mexico J Am Coll Nutr 17,
601-8.
[41] Salvioli G, Lugli R, Pradelli JM (1985) Cholesterol absorption and sterol balance in normal subjects
receiving dietary fiber or ursodeoxycholic acid Dig Dis Sci 30, 301-7.
[42] Winreich J, Pedersen O, Dinesen K (1977) Role of bran in normals. Serum levels of cholesterols,
triglyceride, calcium and total 3 alpha-hydroxycholanic acid, and intestinal transit time Acta Med Scand 202,
125-30.
[43] Jenkins DJ, Kendall CW, Augustin LS, et al. (2002) Effect of wheat bran on glycemic control and risk
factors for cardiovascular disease in type 2 diabetes Diabetes Care 25, 1522-8.
[44] Kashtan H, Stern HS, Jenkins DJ, et al. (1992) Wheat-bran and oat-bran supplements' effects on blood
lipids and lipoproteins Am J Clin Nutr 55, 976-80.
[45] Lewis S, Bolton C, Heaton K (1996) Lack of influence of intestinal transit on oxidative status in
premenopausal women Eur J Clin Nutr 50, 565-8.
[46] Munoz JM, Sandstead HH, Jacob RA, et al. (1979) Effects of some cereal brans and textured vegetable
protein on plasma lipids Am J Clin Nutr 32, 580-92.
[47] Tighe P, Duthie G, Vaughan N, et al. (2010) Effect of increased consumption of whole-grain foods on
blood pressure and other cardiovascular risk markers in healthy middle-aged persons: a randomized controlled
trial Am J Clin Nutr.
[48] Devries JW (2004) Dietary fiber: the influence of definition on analysis and regulation J AOAC Int 87,
682-706.
[49] Van Gaal LF, Mertens IL, Ballaux D (2005) What is the relationship between risk factor reduction and
degree of weight loss? European Heart Journal Supplements 7, L21-L6.
[50] Poobalan A, Aucott L, Smith WC, et al. (2004) Effects of weight loss in overweight/obese individuals
and long-term lipid outcomes--a systematic review Obes Rev 5, 43-50.
[51] Anderson JW, Konz EC (2001) Obesity and disease management: effects of weight loss on comorbid
conditions Obes Res 9 Suppl 4, 326S-34S.








































[52] Mensink RP, Zock PL, Kester AD, et al. (2003) Effects of dietary fatty acids and carbohydrates on the
ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60
controlled trials Am J Clin Nutr 77, 1146-55.
[53] Cao Y, Mauger DT, Pelkman CL, et al. (2009) Effects of moderate (MF) versus lower fat (LF) diets on
lipids and lipoproteins: a meta-analysis of clinical trials in subjects with and without diabetes J Clin Lipidol 3,
19-32.
[54] Anderson JW, Randles KM, Kendall CW, et al. (2004) Carbohydrate and fiber recommendations for
individuals with diabetes: a quantitative assessment and meta-analysis of the evidence J Am Coll Nutr 23, 5-17.
[55] Ylonen K, Saloranta C, Kronberg-Kippila C, et al. (2003) Associations of dietary fiber with glucose
metabolism in nondiabetic relatives of subjects with type 2 diabetes: the Botnia Dietary Study Diabetes Care 26,
1979-85.
[56] Ludwig DS, Pereira MA, Kroenke CH, et al. (1999) Dietary fiber, weight gain, and cardiovascular
disease risk factors in young adults JAMA 282, 1539-46.
[57] De Moura FF. Whole Grain Intake and Cardiovascular Disease and Whole Grain Intake a Diabetes a
Review. Bethesda: Life science Research Office, 2008.
[58] He M, van Dam RM, Rimm E, et al. (2010) Whole-grain, cereal fiber, bran, and germ intake and the
risks of all-cause and cardiovascular disease-specific mortality among women with type 2 diabetes mellitus
Circulation 121, 2162-8.
[59] Jensen MK, Koh-Banerjee P, Hu FB, et al. (2004) Intakes of whole grains, bran, and germ and the risk
of coronary heart disease in men Am J Clin Nutr 80, 1492-9.























... A better-quality breakfast can impact positively on youngsters' mental health (O'sullivan et al., 2009) and improve whole diet quality (Matthys et al., 2007;Raaijmakers et al., 2010). Eating a larger breakfast was also concomitant with better presentation on a test of speaking fluency (Wyon et al., 1997). There were numerous encouraging impacts on mood after breakfast consumption, viz. ...
... Breakfast consumption is believed to be linked with nutritional fulfilment, optimum body weight and educational performance in teenagers as well as children (Albertson et al., 2009;Szajewska & Ruszczynski, 2010). Several other reports also stated that breakfast influenced the output presentation of school-children (Owens et al., 1997;Wyon et al., 1997). Variations in physical activity were also observed for those who had cereal-based breakfast or as an evening meal and found better performance. ...
... The contrary effect of a low-calorie breakfast was overturned by the consumption of a mid-morning snack (Benton & Jarvis, 2007). In Sweden, 9-to 12-year-old schoolgoing children who consumed high-calorie breakfasts and exercised for a longer time in a morning physical exercise class and also scored better in speaking fluency test (Wyon et al., 1997). In 9-to 12-year-old children, breakfast instead of fasting improved mental performance (Mahoney et al., 2005). ...
Article
Full-text available
Breakfast is most important meal of the day and usually taken after night fast or after a long gap. Various health surveys and cross‐sectional studies reported morning meal positive effect on memory recall, children performance, mood, work performance, cognitive function, women health like irregular mensuration and reduction in obesity and effect on body mass index. Still people skip breakfast throughout the world due to several reasons like lack of time, family environment, single‐parent family, not feeling hunger in morning or having several misconceptions like thinking of being obese. Skipping morning meal have an adverse effect on health. This review focuses on awareness of breakfast and its positive impact on health as the breakfast skipping trend is increasing around the world and also drawing the attention of researchers to develop convenient, nutritious breakfast options and awareness programs for significance of breakfast.
... There was no difference in short-term visual memory, level of arousal, degree of impulsiveness, and mood state [3] and no influence on problem solving abilities and concentration [4]. However, Wyon et al. [5] showed statistically significant negative results in creative thinking in terms of comparing a group of 10-year-old school age children that had low calorie and nutritionally insufficient breakfast with a group that had a healthy breakfast. They reported that the children who had breakfast with relatively low calories complained more about hunger and depression. ...
... Regularity of breakfast and lunch was associated with academic performance in most groups. Regularity was related to higher GPA 5) , with the largest magnitude being about one quarter of a point. School achievement appeared to be influenced by breakfast intake as the students with poor school results. ...
... Belot and James (2011) reported more pronounced effects of the "Feed Me Better" campaign for girls, compared to boys. Wyon et al. (1997) found that lower energy intake during breakfast significantly and negatively affected creative thinking in 10-year-old boys but not in girls. ...
Article
Full-text available
Sugary drinks in schools have been demonized for their potential long‐term contribution to rising obesity rates. Surprisingly, there is only little evidence on the immediate effects of sugary drinks in schools. This paper provides experimental evidence on the in‐class effects of sugary drinks on behavior and student achievement. We randomly assigned 462 preschool children to receive sugary drinks or artificially sweetened drinks and collected data before and after consumption. Our findings suggest that the consumption of one sugary drink induces an initial “relaxing” effect for boys, before making them more restless. Girls' behavior is not significantly affected. We find a negative effect on student achievement for boys and a positive effect for girls. We show the robustness of the results across two field experiments.
... 11 Tienen una mejor motivación, memoria y niveles cognitivos superiores asociado con niveles más bajos de glucosa y mejor tolerancia en sangre . [12][13][14][15][16][17] Presentan mejor rendimiento en las pruebas de vigilancia y aritméticas . 14 Tienen una fuerte asociación del efecto del consumo del desayuno con un mejor estado de ánimo . ...
Article
Full-text available
Recibido para publicación: enero 15, 2013 Aceptado para publicación: marzo 30, 2013 RESUMEN En el área de la nutrición y la alimentación, hay algunos temas muy poco tratados y en menor proporción en el campo del profesional de la salud en general, uno de ellos es el del desayuno. Son muchas las investigaciones en la literatura que reportan la importancia de este y que es una de las comidas esenciales del día, con grandes ventajas en el desarrollo físico e intelectual del niño, pero que es la comida que más se omite. Otra de las múltiples ventajas es la que se menciona en uno de los estudios más conocidos realizados en Barcelona y otra serie de reportes en la literatura sobre desayuno y obesidad. Se encontró que la prevalencia de esta es mayor entre los que desayunan poco o los que no lo hacen, y entre las desventajas, es que son más vulnerables a las funciones cerebrales que interfieren en el aprendizaje, sobre todo el grupo de los niños en crecimiento y adultos mayores. Como recomendaciones importantes se debe despertar al niño con suficiente tiempo y que se pueda disponer de 10 a 20 minutos para un desayuno equilibrado por lo que debe ir a dormir a una hora apropiada la noche anterior, dejando el material escolar preparado y que debe ser responsabilidad de los padres romper el círculo vicioso en el niño y resto de la familia de las prisas, el acostarse y levantarse tarde y tener una mejor distribución del tiempo. Al consumir un desayuno completo se podría garantizar un mejor consumo de nutrientes en la dieta con efecto positivo sobre los estudiantes con un buen desempeño escolar. Es importante no sólo el consumo del desayuno sino considerar los elementos que lo integran o la composición del mismo y la hora en que se realice que incluya alimentos de cada uno de los grupos en cantidades adecuadas a cada niño. SUMMARY In the area of nutrition and food are some issues that are little discussed and to a lesser degree in the field of healthcare in general and one of these issues is that of Breakfast. There is a lot of research in literature that report the importance of this, and the breakfast is one of the essential meals of the day, delivering abundant advantages in physical and intellectual development of the child, but still being is the most commonly omitted meal. Another of the many advantages is mentioned in one of the best known studies conducted in Barcelona and a number of reports in the literature on breakfast and obesity. There was found that the prevalence of the last one is higher among those who have little breakfasts or none at all, and among the disadvantages is that they are more vulnerable to brain functions that interfere with learning, especially the group of children growing and older adults. As important recommendations the child should be waken with enough time, so you could have 10-20 minutes for a balanced breakfast, reason why you should go to bed at a decent hour at night, leaving the school supplies ready and that should be the responsibility of parents to break the vicious circle in the child and other family members of the rush, lying down and getting up late, and have better timing. By eating a full breakfast it could be ensured a better absorption of nutrients in the diet with a positive effect on students with good school performance. It is important not only breakfast consumption but considering the elements that it comprises or its composition and the hour in which is eaten includes foods from each of the groups in adequate amounts to each child. INTRODUCCIÓN El tema del desayuno y su importancia en la alimentación diaria ha sido poco tratado dentro del área de la nutrición y aún en menor proporción en el ámbito del profesional de medicina, pediatría, enfermería y otros profesionales de la salud en general. La nutrición y la alimentación durante la infancia y adolescencia tiene una gran trascendencia en la 20
... Belot and James (2011) reported more pronounced effects of the 'Feed Me Better' campaign for girls, compared to boys. Wyon et al. (1997) found that lower energy intake Behavior Notes: This figure plots estimated coefficients and 95% confidence intervals of interactions between the treatment effect, pretreatment test scores, and pretreatment behavior. Higher behavioral scores indicate more restless behavior of children in the classroom. ...
Preprint
Full-text available
Sugary drinks in schools have been demonized for their potential long-term contribution to rising obesity rates. Surprisingly, there is only little evidence on the immediate effects of sugary drinks in schools. This paper provides experimental evidence on the in-class effects of sugary drinks on behavior and student achievement. We randomly assigned 462 preschool children to receive sugary drinks or artificially sweetened drinks and collected data before and after consumption. Our findings suggest that the consumption of one sugary drink induces an initial 'relaxing' effect for boys, before making them more restless. Girls' behavior is not significantly affected. We find a negative effect on student achievement for boys and a positive effect for girls. We show the robustness of the results across two field experiments.
... School lunches may also affect human capital through making pupils more attentive and raising their energy level. Figlio and Winicki (2005) found that schools serving meals richer in carbs on test days improved test scores, a finding that is also supported by experimental research (Wyon and Abrahamsson, 1997). ...
Article
Full-text available
We study the long-term impact of a policy-driven change in childhood nutrition. For this purpose, we evaluate a program that rolled out nutritious school lunches free of charge to all pupils in Swedish primary schools between 1959 and 1969. We estimate the impact of the program on children’s economic, educational, and health outcomes throughout life. Our results show that the school lunch program generated substantial long-term benefits, where pupils exposed to the program during their entire primary school period have 3% higher lifetime income. The effect was greater for pupils that were exposed at earlier ages and for pupils from poor households, suggesting that the program reduced socioeconomic inequalities in adulthood. Exposure to the program also had substantial effects on educational attainment and health, which can explain a large part of the effect of the program on lifetime income.
... There have been multiple researches that demonstrated the role of breakfast; they demonstrated that breakfast influences specific components of cognitive function, including concentration level 3, school performance, attention, and memory. [4][5][6][7][8][9][10][11][12] Further, it was found that the type of breakfast consumed by Japanese children and adolescents can be linked to brain gray and white matter volumes and IQ. 13 Childhood is a critical period in which dietary and lifestyle patterns are initiated, and these habits can have important immediate and long-term implications. 14 Therefore, this study has aimed to study the Intelligence Quotient (IQ) of the children of the age group 3-5 in urban and rural areas and study the factors associated with it. ...
Article
Full-text available
Background: Children are the future of our country and hence their mental and physical wellbeing should be our upmost priority. Undernutrition is a major public health problem in our country and is one of the most common reasons for morbidity and mortality in children under 5yrs of age. The first few years of life are particularly important because vital development occurs in all domains. Therefore, this study has aimed to study the Intelligence Quotient (IQ) of the children of the age group 3-5 in urban and rural areas and study the factors associated with it.Methods: A cross section study of the children group of population was performed. Two sections of the children group were taken for the study- children population residing in an urban area and children population residing in a rural community of Rajasthan, India. The data was compiled and analyzed using appropriate statistical methods.Results: In our study, we have found that The following chosen demographic factors were found associated with children Intelligence quotient (IQ) - nutritional status, socioeconomic status, and age, while gender was not found to be associated with IQ.Conclusions: As, cognitive development is fairly important to children and their future, it should be paid more acknowledgment, as well as early preventive methods of it’s associated factors.
... First, some of the treatment meals may have deviated from what children habitually consume in the morning, owing to how treatment foods are normally eaten in mixed meal settings, total caloric content, and individual preference. There is evidence that foods dissimilar in composition or energy content to those habitually consumed can adversely affect cognitive performance (Adolphus et al. 2017;Lloyd et al. 1994;Wesnes et al. 2003;Wyon et al. 1997). However, it is unclear if consuming these meals at a different time of day would have improved cognitive performance scores, but it is an important consideration for further research in children as noted in our previous review (Adolphus et al. 2017). ...
Article
Dietary carbohydrates have been shown to influence cognitive performance and satiety in children. However, it remains unclear whether the carbohydrate source is a primary determinant of cognitive performance and satiety. The objective was to compare the effects of white potatoes and other carbohydrate-containing foods on cognitive performance, glycemic response, and satiety in children. On 6 separate mornings, in random order, children (n = 22) consumed 50 g of available carbohydrates from microwaved mashed potatoes (prepared from fresh potatoes then frozen), deep-fried potato strips (French fries), hash browns, white rice, white beans, or skipped a meal. Cognitive performance, glycemic response, and satiety were measured over 180 min. Cognitive performance was measured using a battery of tests assessing verbal declarative memory, spatial memory, short-term memory, working memory, and information processing speed. Although cognitive performance after the treatment meals did not differ from meal skipping, children recalled more words after French fries (9.1 ± 0.4 words) compared with mashed potatoes (8.2 ± 0.3 words; p = 0.001) and white rice (8.4 ± 0.3 words; p = 0.04) on the verbal declarative memory test. Blood glucose concentrations were higher after white rice compared with white beans, mashed potatoes, and hash browns (p < 0.05). Change from baseline subjective average appetite (mm/kcal) was lower after mashed potatoes compared with all other treatment meals (p < 0.05). In conclusion, verbal declarative memory was higher after French fries and subjective average appetite was lower after mashed potatoes. Future longitudinal studies are needed to confirm these short-term findings and to elucidate the mechanism of action.
... Children who eat breakfast more often also engage in PA more frequently. Although a few studies previously found that daily breakfast was not significantly associated with PA, 49,50 breakfast consumption has also been regarded as a protective factor for obesity 46 and has been linked to longer PA, 51 and our findings lean toward this direction. PA intervention programs should thus consider targeting to increase breakfast consumption among school-aged children. ...
Article
Full-text available
BACKGROUND Physical activity (PA) has long been acknowledged to contribute health benefits among children. However, research has consistently shown that PA declines as children grow older. Thus, this study examined the factors which are associated to children's PA in order to identify potential barriers to PA. METHODS Using data from the KidQuest Program, we conducted bivariate and multivariate analyses on survey data collected from fifth to seventh grade students in a small Midwestern city. RESULTS We found that food knowledge, eating breakfast, and talking with family about eating healthy foods, are positively related to PA. On the other hand, screen time is negatively related to PA. In addition, our results evinced differences between ethnicities and found that Latino children's screen time affects their PA levels more than their white counterpart. CONCLUSIONS There are different factors which can be tapped to increase PA among middle school‐aged children. Given the differences between the Latino and white samples especially in screen time, schools should consider individualized intervention, rather than a “one size fits all” program, to increase PA participation.
Article
Full-text available
El presente trabajo estima el efecto causal del Programa de Alimentación Escolar (PAE) sobre el rendimiento académico de los estudiantes del sector oficial, de grado once, del municipio de Ibagué en el 2018, utilizando la información del Simat y la base de datos de las pruebas Saber 11 del Icfes. Metodológicamente se utiliza un modelo econométrico de evaluación de impacto que se basa en la técnica de propensity score matching PSM para identificar el efecto causal. Los resultados sugieren que el programa no tuvo ningún impacto sobre el desempeño académico de los estudiantes. Los problemas asociados a la asignación del operador y a la gestión del programa parecen haber influido de forma significativa sobre la efectividad del programa.
Article
Full-text available
To test the hypothesis that participation in the School Breakfast Program by low-income children is associated with improvements in standardized achievement test scores and in rates of absence and tardiness, children in grades 3 through 6 were studied in the Lawrence, Mass, public schools, where the School Breakfast Program was begun at the start of the second semester 1986-1987 school year. The changes in scores on a standardized achievement test and in rates of absence and tardiness before and after the implementation of the School Breakfast Program for children participating in the program were compared with those of children who also qualified but did not participate. Controlling for other factors, participation in the School Breakfast Program contributed positively to the 1987 Comprehensive Tests of Basic Skills battery total scale score and negatively to 1987 tardiness and absence rates. These findings suggest that participation in the School Breakfast Program is associated with significant improvements in academic functioning among low-income elementary school children.
Article
Full-text available
We examined the effects of omitting breakfast on the cognitive functions of three groups of children: stunted, nonstunted controls, and previously severely malnourished. They were admitted to a metabolic ward twice. After an overnight fast half the children received breakfast on their first visit and a cup of tea the second time. The treatment order was reversed for the other half. When breakfast was omitted, both the stunted and previously malnourished groups responded similarly. The malnourished groups had lower scores in fluency and coding whereas the control group had higher scores in arithmetic. The children were divided into wasted and nonwasted groups. Wasted children were adversely affected in the digit span backwards tests, and wasted members of the malnourished groups were adversely affected in efficiency of problem solving and those in the control group in digit span forwards. These results indicate that cognitive functions are more vulnerable to missing breakfast in poorly nourished children.
Article
We examined the effects of omitting breakfast on the cognitive functions of three groups of children: stunted, nonstunted controls, and previously severely malnourished. They were admitted to a metabolic ward twice. After an overnight fast half the children received breakfast on their first visit and a cup of tea the second time. The treatment order was reversed for the other half. When breakfast was omitted, both the stunted and previously malnourished groups responded similarly. The malnourished groups had lower scores in fluency and coding whereas the control group had higher scores in arithmetic. The children were divided into wasted and nonwasted groups. Wasted children were adversely affected in the digit span backwards tests, and wasted members of the malnourished groups were adversely affected in efficiency of problem solving and those in the control group in digit span forwards. These results indicate that cognitive functions are more vulnerable to missing breakfast in poorly nourished children.
Article
Military operations, almost by definition, involve high levels of stress. Survival in this hostile environment depends on effective performance. Yet, it is ironic that these times when performance is most crucial are often the times when individuals are under the greatest stress, and when stress-induced decrements are most likely to occur--skilled performance declines, poor decisions are made, and crucial information is ignored. The effects of stress on task performance, and the mitigation of these effects through training are areas of critical concern to the military. The following research examines human performance under stress, and presents a theoretical model for understanding the determinants and performance consequences of acute stress. Two experiments are reported to substantiate this model. The first examines the determinants of performance stress in a military training setting. A second examines consequences of stress on performance, in a team task environment. Keywords: Human performance, Psychological stress, Training, Team performance, Military training.
• To test the hypothesis that participation in the School Breakfast Program by low-income children is associated with improvements in standardized achievement test scores and in rates of absence and tardiness, children in grades 3 through 6 were studied in the Lawrence, Mass, public schools, where the School Breakfast Program was begun at the start of the second semester 1986-1987 school year. The changes in scores on a standardized achievement test and in rates of absence and tardiness before and after the implementation of the School Breakfast Program for children participating in the program were compared with those of children who also qualified but did not participate. Controlling for other factors, participation in the School Breakfast Program contributed positively to the 1987 Comprehensive Tests of Basic Skills battery total scale score and negatively to 1987 tardiness and absence rates. These findings suggest that participation in the School Breakfast Program is associated with significant improvements in academic functioning among low-income elementary school children. (AJDC. 1989;143:1234-1239)
Article
The hypothesis that blood glucose levels influence memory was re-examined. The performance on two memory tests was quicker when breakfast had been taken, suggesting that the ability to retrieve memories had been facilitated. Performance on a spatial memory test correlated significantly with blood glucose levels.
Article
Effects of breakfast size on blood glucose, mood, short-term memory and concentration were assessed in 319 adolescents (age 13-20 years) in real-life setting. Mean energy increase of 63% over habitual breakfast had no effect on blood glucose or late morning mood. High energy intake from breakfast had a beneficial effect on immediate recall in short-term memory evaluated on the whole sample. However, concentration appeared to be impaired by a high caloric breakfast. There were no differences in the studied parameters according to energy supplement size. The present results are consistent with suggestions that meal size supplement has an effect on cognitive function.
Article
Selection of dietary assessment methodology is important in dietary intervention studies. Few studies have reported the relative merits of various assessment methods or the feasibility of electronic methods in pediatric populations. Parent-child dyads performed telephone recalls (no. = 32) and tape recorded dietary records (no. = 33). Traditional recalls were first conducted to familiarize parents and children with the telephone recall procedure, to introduce two-dimensional food models, and to instruct on the use of the tape recorder. Parents monitored and documented as unobtrusively as possible the child's intake on the day before the telephone recall and also on the day of the taped record. Children were called at random to reduce bias. Simple correlation coefficients (r) were calculated for nine nutrients and calories for both methods. For telephone recalls, values ranged from a low of r = .64 for saturated and polyunsaturated fat to r = .85 for cholesterol and r = .93 for iron. Tape-recorded data yielded r = .80 or above, except calories with r = .68 (p less than .001 for all values, 1-tail tests). Mean nutrient values were within expected ranges, e.g., 1,800 kcal +/- 500, with saturated fat about 14% of calories per day. Comparisons between parents and childrens reports of food frequencies and portion sizes revealed the best correlations for beverages, bread-cereals-crackers, meat-fish-poultry, and mixed dishes. We conclude that preadolescent children are able to provide dietary intake data using electronic methods in a manner that compares favorably with their parents' written records.
Article
We evaluated the effects of giving the standard Jamaican government school meal to a class of school children. Unlike many other school-feeding studies, this project was carefully controlled and carried out with undernourished children who had low levels of school attendance and achievement. In spite of this, no improvement was found in the children's nutritional status as reflected by weight for age. However, small benefits were found in attendance and school achievement. These findings remained when sex, age, improvements over the previous term, and the effects of 'benevolent attention' were taken into account.